# MICHELLE GONZALEZ OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962698431
- **Authorized official:** MICHELLE GONZALEZ O.D. (PRESIDENT)
- **Authorized official phone:** (954) 484-0700

## Contact information

- **Practice address:** 4300 W OAKLAND PARK BLVD, LAUDERDALE LAKES, FL 33313-1918
- **Practice address phone:** (954) 484-0700
- **Practice address fax:** (954) 484-0705
- **Mailing address:** 4300 W OAKLAND PARK BLVD, LAUDERDALE LAKES, FL 33313-1918
- **Mailing address phone:** (954) 484-0700
- **Mailing address fax:** (954) 484-0705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC3797 | FL | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 11/09/2007